1989
Year 09
Prof. Jean Aicardi
Director
Institut National de la Santé et de la Recherche Médicale (INSERM), France
THEME: EPILEPSY IN INFANTS AND CHILDREN: AN OVERVIEW
During the neonatal period extending to three months, the brain is immature, with short cell processes,
limited nerve connections, slow conduction (due to absence of myelin) and better developed inhibitory
rather than excitatory synapses. Due to anatomical and physiological considerations, the seizures follow a
specific pattern and are often localised. However, the prognosis is poor, if these seizures are caused by gross
brain lesions.
From three months to four years, major changes occur in the brain, with increased development of cell processes, maturity of synapses, myelin deposition and increase in brain weight, acquiring in the period most of the features of the adult brain. At the same time, cortical excitability also increases and the long nerve tracts become functional. The clinical correlates of these changes are the enormous increase in propensity of seizures due to benign causes, as in the case of febrile fits which occur without any lesion in the brain. Many prenatal brain malformations manifest seizures during this period for the first time. Epileptic syndromes like the West’s syndrome are among the most severe of these.
From three months to four years, major changes occur in the brain, with increased development of cell processes, maturity of synapses, myelin deposition and increase in brain weight, acquiring in the period most of the features of the adult brain. At the same time, cortical excitability also increases and the long nerve tracts become functional. The clinical correlates of these changes are the enormous increase in propensity of seizures due to benign causes, as in the case of febrile fits which occur without any lesion in the brain. Many prenatal brain malformations manifest seizures during this period for the first time. Epileptic syndromes like the West’s syndrome are among the most severe of these.
